ERA Denials/Billing Specialist
IMA Medical Group, Orlando, FL, United States
We are excited to announce an opening for a
ERA Denials/Billing Specialist . As a
ERA Denials/Billing Specialist
you will be responsible for managing the electronic remittance advice (ERA) process and resolving denied claims. This position requires a keen understanding of healthcare billing processes, proficiency in navigating electronic billing systems, and the ability to effectively analyze and address denial reasons.
ERA Management: Review electronic remittance advice (ERA) files received from payers to ensure accuracy and completeness. Identify and reconcile discrepancies between claims and corresponding payment information.
Denial Analysis: Analyze claim denials to determine root causes and reasons for rejection.
Collaborate with relevant departments to address and rectify issues leading to denials.
Claim Resubmission: Develop and implement strategies to correct denied claims for resubmission. Ensure timely and accurate resubmission of corrected claims to maximize reimbursement.
Communication: Liaise with payers to resolve ERA discrepancies and denial-related inquiries.
Communicate effectively with internal teams to provide insights into denial trends and solutions.
Documentation: Maintain detailed records of denial reasons, resolutions, and follow‑up actions.
Generate reports on denial trends and share findings with management.
Process Improvement: Identify opportunities for process improvement to minimize future denials.
Collaborate with cross‑functional teams to implement enhancements in billing and claims processes.
Training and Education: Provide training to billing and coding staff on best practices to prevent denials. Stay informed about changes in payer policies and regulations affecting claims processing.
Required
Minimum of 2 years experience in healthcare billing and claims management.
Proficiency in working with electronic health records (EHR) and billing software.
Strong analytical skills with the ability to interpret ERA files and analyze denial trends.
Excellent verbal and written communication skills.
Ability to communicate effectively with payers, internal teams, and other stakeholders.
Keen attention to detail in reviewing and reconciling claims and payment information.
Proven ability to identify and address root causes of claim denials.
Preferred
Fully Bilingual (ENGLISH/SPANISH).
Athena experience.
TriZetto/Gateway preferred
Bachelor's degree in Healthcare Administration, Business, or a related field.
What We Offer
A welcoming and inclusive work environment
Opportunities for professional growth and development
Competitive salary and benefits package
Health, Dental, and Vision Insurance
401(K) Retirement Plan with Matching
Voluntary Short & Long-Term Disability
Employer-Paid Life Insurance
Paid Time Off, Floating Holidays, and Paid Major Holidays
Employee Assistance Program (EAP)
IMA Medical Group is an Equal Opportunity Employer (EOE) and we comply with all federal, state, and local anti‑discrimination laws, regulations, and ordinances.
IMA Medical Group participates in E‑Verify, as required by the Florida Medicaid program.
IMA maintains a drug‑free workplace in accordance with applicable Federal and State laws.
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ERA Denials/Billing Specialist . As a
ERA Denials/Billing Specialist
you will be responsible for managing the electronic remittance advice (ERA) process and resolving denied claims. This position requires a keen understanding of healthcare billing processes, proficiency in navigating electronic billing systems, and the ability to effectively analyze and address denial reasons.
ERA Management: Review electronic remittance advice (ERA) files received from payers to ensure accuracy and completeness. Identify and reconcile discrepancies between claims and corresponding payment information.
Denial Analysis: Analyze claim denials to determine root causes and reasons for rejection.
Collaborate with relevant departments to address and rectify issues leading to denials.
Claim Resubmission: Develop and implement strategies to correct denied claims for resubmission. Ensure timely and accurate resubmission of corrected claims to maximize reimbursement.
Communication: Liaise with payers to resolve ERA discrepancies and denial-related inquiries.
Communicate effectively with internal teams to provide insights into denial trends and solutions.
Documentation: Maintain detailed records of denial reasons, resolutions, and follow‑up actions.
Generate reports on denial trends and share findings with management.
Process Improvement: Identify opportunities for process improvement to minimize future denials.
Collaborate with cross‑functional teams to implement enhancements in billing and claims processes.
Training and Education: Provide training to billing and coding staff on best practices to prevent denials. Stay informed about changes in payer policies and regulations affecting claims processing.
Required
Minimum of 2 years experience in healthcare billing and claims management.
Proficiency in working with electronic health records (EHR) and billing software.
Strong analytical skills with the ability to interpret ERA files and analyze denial trends.
Excellent verbal and written communication skills.
Ability to communicate effectively with payers, internal teams, and other stakeholders.
Keen attention to detail in reviewing and reconciling claims and payment information.
Proven ability to identify and address root causes of claim denials.
Preferred
Fully Bilingual (ENGLISH/SPANISH).
Athena experience.
TriZetto/Gateway preferred
Bachelor's degree in Healthcare Administration, Business, or a related field.
What We Offer
A welcoming and inclusive work environment
Opportunities for professional growth and development
Competitive salary and benefits package
Health, Dental, and Vision Insurance
401(K) Retirement Plan with Matching
Voluntary Short & Long-Term Disability
Employer-Paid Life Insurance
Paid Time Off, Floating Holidays, and Paid Major Holidays
Employee Assistance Program (EAP)
IMA Medical Group is an Equal Opportunity Employer (EOE) and we comply with all federal, state, and local anti‑discrimination laws, regulations, and ordinances.
IMA Medical Group participates in E‑Verify, as required by the Florida Medicaid program.
IMA maintains a drug‑free workplace in accordance with applicable Federal and State laws.
#J-18808-Ljbffr